HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/CS/HB 1567 Elder and Vulnerable Adult Abuse Fatality Review Teams
SPONSOR(S): Health & Human Services Committee, Children, Families & Seniors Subcommittee, Hawkins
TIED BILLS: HB 1569 IDEN./SIM. BILLS: SB 1540
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Children, Families & Seniors Subcommittee 17 Y, 0 N, As CS Osborne Brazzell
2) Health & Human Services Committee 19 Y, 0 N, As CS Osborne Calamas
SUMMARY ANALYSIS
In 2022, Florida had an estimated 4.7 million people age 65 and older, making up approximately 21 percent of
the state’s population. Mental and physical infirmities associated with aging and social isolation make elders
vulnerable to abuse, which increases their rates of hospitalization and hastens death. One in 10 elders is
abused, but less than 5 percent of cases are reported. This is believed to be primarily because perpetrators
are usually a relative, friend, neighbor, or caregiver whom the elder trusts or fears.
Current law authorizes multidisciplinary, multiagency elder abuse fatality review teams (EA-FRTs) to be
established in each judicial circuit. EA-FRTs review closed cases where the death of an elderly person was
caused by, or related to, abuse or neglect in order to produce recommendations for improvements to the
systems involved in caring for elderly adults. An EA-FRT may only be initiated by a state attorney, and may
only review closed cases which have been referred by the state attorney. This limits EA-FRTs to reviewing only
cases which have been opened or criminally prosecuted by the state attorney’s office. Currently only two EA-
FRTs exist, one in the Fourth Judicial Circuit and the other in Fifth Judicial Circuit.
The 2nd Annual Report from the Fourth Judicial Circuit’s EA-FRT included a series of recommendations for
changes to Florida Statute to allow for more comprehensive review of cases. The recommendations included
removing statutory restrictions on the types of cases which an EA-FRT may review, removing the requirement
that EA-FRTs be initiated by a state attorney, and creating public records and meeting exemptions.
CS/CS/HB 1567 expands the scope of the existing EA-FRTs to include vulnerable adults, such as disabled
adults, and persons over 60 recovering from short-term disabilities or surgery. The bill also expands the scope
of the review teams to include incidents which are the result of exploitation. The bill removes the requirement
that a state attorney be the entity that initiates the team; alternatively, the bill allows a state attorney, law
enforcement agency, the Department of Children and Families, the Office of the Attorney General, and the
Agency for Persons with Disabilities to initiate a review team. The bill requires that a representative of the
initiating entity serve as a co-chair of the review team. The bill also requires that the initiating entity specify the
geographic area being served by the review team; the geographic area that may be served by the review team
is restricted to the service area of the initiating entity.
CS/CS/HB 1567 excludes individuals interviewed and information collected by review teams from use in a civil
or criminal proceeding. The bill removes the provision restricting review teams to reviewing only closed cases
referred by a state attorney. The bill also prohibits members of a review team from directly contacting members
of a deceased victim’s family except under specified circumstances. The bill requires review team members to
sign an acknowledgement of their obligations to adhere to public records requirements. The initiating entity
must provide the acknowledgement form, and provide training on public records requirements to review team
members.
The bill has no fiscal impact on state or local governments.
The bill provides an effective date of July 1, 2023.
This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives .
STORAGE NAME: h1567c.HHS
DATE: 4/25/2023
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Current Situation
Elder Population in Florida
As the country’s “baby-boom” population reaches retirement age and life expectancy increases, the
nation’s elder population is projected to increase from 54.1 million in 2019 1 to 80.8 million by 2040.2
Florida has long been a destination state for senior citizens and has the second highest percentage of
senior residents in the nation.3 In 2022, Florida had an estimated 4.7 million people age 65 and older,
approximately 21 percent of the state’s population.4 By 2030, this number is projected to increase to
5.9 million, meaning the elderly will make up approximately one quarter of the state’s population and
will account for most of the state’s growth.5
National Distribution of Population Ages 65 and Older (2021) 6
In Florida, almost 1.5 million senior citizens live in medically underserved areas and 758,000 have one
or more disabilities.7
Abuse of Elderly Persons and Vulnerable Adults
1 U.S. Census Bureau, 65 and Older Population Grows Rapidly as Bab y Boomers Age (June 25, 2020), Release Number: CB20-99,
https://www.census.gov/newsroom/press-releases/2020/65-older-population-grows.html (last visited March 19, 2023).
2 U.S. Department of Health and Human Services Administration on Aging, 2020 Profile of Older Americans (May 2021),
https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2020ProfileOlderAmericans.Final_.p df (last visited
March 19, 2023).
3 Id.
4 U.S. Census Bureau, Quick Facts – Florida. Available at https://www.census.gov/quickfacts/fact/table/FL# (last visited Jan. 26, 2022).
5 Florida Office of Economic & Demographic Research, Florida Population b y Age Group. Available at
http://edr.state.fl.us/Content/population-demographics/data/pop_census_day-2020.pdf (last visited March 19, 2023).
6 Kaiser Family Foundation, State Health Facts, Population Distrib ution b y Age, https://www.kff.org/other/state-indicator/distribution-by-
age/ (last visited Feb. 13, 2020). Kaiser Family Foundation, State Health Facts, Population Distrib ution by Age. Available at
https://www.kff.org/other/state-indicator/distribution-by-age/ (last visited March 19, 2023).
7 Department of Elder Affairs, 2021 Profile of Older Floridians. Available at https://elderaffairs.org/wp-content/uploads/2021_Florida-
Profile.pdf (last visited March 19, 2023).
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Under Chapter 415, F.S., the Adult Protective Services Act, a “vulnerable adult” is considered a person
18 years of age or older whose ability to perform the normal activities of daily living or to provide for his
or her own care or protection is impaired due to a mental, emotional, sensory, long-term physical, or
developmental disability or dysfunction, brain damage, or the infirmities of aging.8 The term implicitly
includes elderly persons, but also incorporates disabled adults and other adults whom the Legislature
has determined to be at risk of abuse, neglect, and exploitation, and in need of protective services. 9
Elder populations are particularly vulnerable to abuse and exploitation due to risk factors associated
with aging, such as physical and mental infirmities and social isolation. 10 Elder abuse occurs in
community settings, such as private homes, as well as in institutional settings like nursing homes and
other long-term care facilities. Prevalent forms of abuse are financial exploitation, neglect, emotional or
psychological abuse, and physical abuse; a victim of elder abuse will often experience multiple forms of
abuse at the same time.11 The most common perpetrators of elder abuse are relatives, such as adult
children or a spouse, followed by friends and neighbors, and then home care aides. 12 Research shows
that elder abuse is underreported, often because the victims fear retribution or care for or trust their
perpetrators.13
The United States Department of Justice estimates that approximately one in 10 seniors is abused
each year in the United States, although only one out of every 23 cases of elder abuse are reported to
local authorities.14 Elder abuse can have significant physical and emotional effects on an older adult
and can lead to premature death.15 Abused seniors are twice as likely to be hospitalized and three
times more likely to die than non-abused seniors.16 Elder abuse deaths are more likely to go
undetected because an elder death is expected to occur, due to age or infirmity, more so than other
deaths due to abuse such as a child death or a death involving domestic violence. 17 Experts believe
this may be one of the reasons elder abuse lags behind child abuse and domestic violence in research,
awareness, and systemic change.18
Florida’s Adult Protective Services System
Florida’s Adult Protective Services system is established in ch. 415, F.S., and operates under the
Department of Children and Families (DCF). DCF protects vulnerable adults from abuse, neglect, and
exploitation through mandatory reporting and investigation of suspected abuse. 19 This includes deaths
allegedly due to abuse, neglect, and exploitation.20 In 2022, DCF received 30,581 reports of abuse,
neglect, or exploitation of persons aged 60 or older and investigated 206 deaths in which the death was
8 S. 415.102(28), F.S.
9 S. 415. 101, F.S.
10
National Center on Elder Abuse, Research, Statistics, and Data: Risk Factors and Protective Factors. Available at
https://ncea.acl.gov/About-Us/What-We-Do/Research/Statistics-and-Data.aspx#risk (last visited March 19, 2023); U.S. Department of
Justice, What is Elder Ab use. Available at https://www.justice.gov/elderjustice/about-elder-abuse (last visited March 19, 2023). See
also, Xing Qi Dong, et al., Elder Ab use as a Risk Factor for Hospitalization in Older Persons, JAMA Intern Med. 173:10 at 911-917
(2013).
11 National Center on Elder Abuse, Research, Statistics, and Data Behavioral Health: Social Conditions, Violence, and Elder
Mistreatment. Available at https://ncea.acl.gov/What-We-Do/Research/Statistics-and-Data.aspx (last visited March 19, 2023).
12 National Center on Elder Abuse, Research, Statistics, and Data: Perpetrator Identity. Available at https://ncea.acl.gov/About-
Us/What-We-Do/Research/Statistics-and-Data.aspx#perpetrators (last visited March 19, 2023).
13 Center for Disease Control and Prevention, Understanding Elder Ab use, Fact Sheet 2021. Available at
https://www.cdc.gov/violenceprevention/pdf/elder/preventingElderAbuseFactsheet.pdf (last visited Jan. 26, 2022).
14
U.S. Department of Justice, Elder Ab use Statistics. Available at https://www.justice.gov/file/1098056/download (last visited March 19,
2023). See also, Ron Acierno et al., Prevalence and Correlates of Emotional, Physical, Sexual, and Financial Ab use and Potential
Neglect in the United States: The National Elder Mistreatment Study, 100:2 Am. J. Pub. Health, at 292-297 (Feb. 2010),
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2804623/ (last visited March 19, 2023).
15 Id. See also, Mark S. Lachs et al., The Mortality of Elder Mistreatment, 280:5 JAMA at 428-432 (1998),
https://jamanetwork.com/journals/jama/fullarticle/187817 (last visited March 19, 2023).
16 Xing Qi Dong et al., Elder Ab use as a Risk Factor for Hospitalization in Older Persons, JAMA Intern Med. 173:10 at 911-917 (2013).
17 U.S. Department of Justice, National Institute of Justice, Elder Justice Roundtab le Report: Medical Forensic Issues Concerning
Ab use and Neglect, October 18, 2000, p. 8. Available at https://www.ncjrs.gov/pdffiles1/nij/242221.pdf (last visited March 19, 2023).
18 Id. at pp. 7-10.
19 S. 415.101(2), F.S.
20 Department of Children and Families, CF Operating Procedure No. 140-2: Adult Protective Services (2022), pp. 4-9 - 4-10. Available
at https://www.myflfamilies.com/sites/default/files/2022-12/cfop_140-02_adult_protective_services.pdf (last visited March 19, 2023).
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allegedly due to abuse or neglect.21 DCF verified 5,167 of the reported allegations of abuse or neglect,
37 of which involved a fatality. Eighty-one (81) percent of these reports were from in-home settings,
which is consistent with the research findings that relatives, friends, or caregivers are the primary
perpetrators of elder abuse.22
Confidentiality of Reports and Records Concerning Vulnerable Adults
Current law protects all records concerning reports of abuse, neglect, or exploitation of a vulnerable
adult, including reports made to the central abuse hotline operated by DCF, 23 and all records generated
as a result of those reports are confidential and exempt 24 from public record requirements.25 Access 26
to these records is granted only to the following entities in specified circumstances:
DCF, Agency for Health Care Administration (AHCA), Department of Elder Affairs (DOEA), and
Agency for Persons with Disabilities (APD) employees or agents with certain relevant
responsibilities, or the employees or agents of an agency of another state with jurisdiction
similar to those agencies;
A criminal justice agency investigating a report of known or suspected abuse, neglect, or
exploitation of a vulnerable adult;
The state attorney of the judicial circuit in which the vulnerable adult resides or in which the
alleged abuse, neglect, or exploitation occurred;
Any victim, the victim’s guardian, caregiver, or legal counsel, and any person whom DCF has
determined might be abusing, neglecting, or exploiting the victim;
A court;
A grand jury, by subpoena upon its determination that access to such records is necessary;
An official of the Florida advocacy council, State Long-Term Care Ombudsman program, or
long-term care ombudsman council;
Any person engaged in bona fide research or auditing, so long as the identifying information is
not made available;
The Public Employees Relations Commission for the sole purpose of obtaining evidence for
appeals; and
Any person in the event of the death of a vulnerable adult determined to be a result of abuse,
neglect, or exploitation.27
Additionally, the identity of any person reporting abuse, neglect, or exploitation of a vulnerable adult
may not be released, without that person’s consent, to any person other than the employees of DCF
responsible for protective services, the central abuse hotline, or the appropriate state attorney or law
enforcement agency.28
Central Abuse Hotline
DCF maintains a statewide 24/7 toll-free central abuse hotline where anyone can report known or
suspected abuse, neglect, or exploitation.29 This includes, but is not limited to, vulnerable adults. Any
person who knows or has reasonable cause to suspect abuse, neglect, or exploitation of a vulnerable
21 Email from Tarah Yeager, Gubernatorial Fellow, Department of Children and Families, Re: APS Statistics Info Request (March 2 2,
2023). On file with the Health and Human Services Committee.
22 Id.
23
S. 415.103(1), F.S.
24 There is a difference between records the Legislature designates exempt from public record requirements and those the Legislature
deems confidential and exempt. A record classified as exempt from public disclosure may be disclosed under certain circumstances.
See WFTV, Inc. v. Sch. Bd. of Seminole, 874 So.2d 48, 53 (Fla. 5th DCA 2004), review denied 892 So.2d 1015 (Fla. 2004); City of
Riviera Beach v. Barfield, 642 So.2d 1135 (Fla. 4th DCA 1994); Williams v. City of Minneola, 575 So.2d 683, 687 (Fla. 5th DCA 1991).
If the Legislature designates a record as confidential and exempt from public disclosure, such record may not be released, by the
custodian of public records, to anyone other than the persons or entities specifically designated in statute. See Op. Att’y Gen. Fla. 85-
62 (1985).
25 S. 415.107, F.S.
26 The term “access” is defined to mean a visual inspection or copy of the hard -copy record maintained in the district. S. 415.07(7), F.S.
27 S. 415.107(3), F.S.
28 S. 415.107(6), F.S.
29 S. 415.103(1), F.S.
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adult is required to immediately report this knowledge or suspicion to the central abuse hotline. 30 The
hotline number must be provided to clients in nursing homes 31 and publicly displayed in every health
facility licensed by the Agency for Health Care Administration (AHCA). 32 The number is also listed on
the agency websites for DCF, AHCA, and the Department of Elder Affairs (DOEA). 33
Additionally, any person who is required to investigate allegations of abuse, neglect, or exploitation,
and who has reasonable cause to suspect that a vulnerable adult died as result of such harm must
report that suspicion to DCF, the medical examiner, and appropriate criminal justice agency.34 Medical
examiners in turn are required to consider this information in their cause of death determinations and
report their findings to DCF and the appropriate criminal justice agency and state at